I want to be super clear: I am a BIG fan of birth plans. You can read some of my tips for writing a birth plan here. The act of learning about your options and exploring different procedures that can occur during labor is powerful. And then the actual document as a tool for sparking discussion with your provider and for communicating your wishes when you are deep in the work of labor is extremely useful. But the truth is, sometimes things don’t go the way you expect.
I think we all know intellectually that things may take an unexpected turn in labor. We’ve heard enough birth stories from our friends to know that all kinds of things can happen. But it can still take us completely off guard when it happens to us, especially when it’s something that changes our plan in a flash.
As a doula and childbirth educator, I want to prepare my students and clients for the realities and possibilities of labor and birth without scaring them with scenarios they hadn’t even thought of. Mothers and their partners tend to worry about how labor and birth will go, and I don’t want to make that worry worse. My goal is to send them into their births feeling confident and well-prepared. And I do teach that it’s important to have a flexible mindset going into birth. But sometimes you can know intellectually that your plan may have to change and still be blindsided when it happens.
I recently had a client whose number one goal for birth was to avoid a cesarean if possible. She anticipated a labor in which her contractions would begin and build in intensity, and she was ready to do some hard work. Then one day, her water broke. She was barely feeling any contractions when she arrived at the hospital to get checked out. When she got there, she was informed that her baby was breech and she would need a cesarean. From the time her water broke to the time she was holding her baby was less than 4 hours, and she had to begin recovering from a major surgery. It was a shocking experience. (She and her partner have given me permission to share their story.)
So what can you do when the rug gets yanked out from under you?
First, prepare ahead of time for the unexpected. Ok, so this isn’t something you can do in the moment if your birth plan is headed for the nearest exit. But it is helpful, so I’m including it here. With my clients who I mentioned above, I feel I didn’t adequately prepare them for the possibility that none of their birth plan would apply. This is something I need to pay more attention to with future clients. They were ready for some changes, like the possibility that after laboring for a while, a cesarean could be needed, but not for the lightning fast left turn they experienced. So just know ahead of time that things can go differently–drastically differently–from how you envision. And sometimes that’s how they will need to go for your safety or your baby’s–there won’t be anything you can do to change the situation.
Second, take a deep breath. I know that sounds cliche, but taking some deep breaths can help to calm your body down enough to think clearly. Slow breaths are helpful, especially when the out breath is twice as long as the in breath. I like to breathe in for a count of 4 and out for a count of 8, in through the nose and out through the mouth, breathing deep into the belly. This pattern reduces the “fight, flight, or freeze” response of the sympathetic nervous system. It can help you to remain calm and think more clearly in a stressful situation.
Third, ask the question, “What are my options NOW?” Everything may have changed, but in most cases you will still have some choices. Taking advantage of the options you do have can help you feel a little more in control. For example, if you’re facing an unexpected cesarean, what are your preferences for that kind of birth? Do you want clear drapes? Skin-to-skin in the O.R.? No extraneous chatter during surgery? Do you want to skip anti-anxiety meds in your IV? (This also goes back to point one, which is to plan for the unexpected. Even if having a cesarean is something you think unlikely, it’s good to include preferences for a cesarean on your birth plan.) And the truth is, in some emergencies, you may not have time to make decisions.
Last, expect that you will need time to process what’s happened. You may need to talk through your experience with multiple people, maybe including a professional counselor. You may feel angry with people on your support team or just angry in general. Having a good outcome in terms of a “Healthy Mom, Healthy Baby” does not mean that you will immediately be a-ok with everything that happened. It’s completely normal to have big feelings about your birth. It’s important to give yourself time and space to process the experience, and it can really help to have a good person to debrief with.
Did your birth take an unexpected turn? How did you cope with it? Please share your experience in the comments.
